Canker Sores (Aphthous Ulcers)

When you have canker sores, you may not be able to eat anything, particularly hot or acidic foods. Canker sores can develop due to various factors. Today let’s find out more about canker sores.

Canker sores or aphthous ulcers are a type of mouth sore. They usually appear as white or yellowish round or oval shapes with a red margin inside the mouth. The size can be as small as 1 millimeter or grow to 1/2 inch to 1 inch in diameter. This mouth ulcer type can cause pain and irritation when eating, drinking, or talking. Oral injuries, acidic foods, or stress can be the causes of canker sores which can naturally go away on their own within two weeks. Typically, they are not infected, but a bacterial complication can supervene.

Types of canker sores

Simple canker sores could occur 3-4 times annually and resolve within two weeks.
Complex canker sores are less common and develop in people with a history of canker sores or weak immunity.

Canker sores are different from cold sores or fever blisters, which are fluid-filled blisters caused by herpes simplex virus type 1 (HSV-1) or type 2 (HSV-2). They can affect your mouth and genitals and spread through kissing or oral sex.

Symptoms

You can develop one or more canker sores on the tongue, inner cheeks, inner lips, or on the roof of the mouth. You feel the burning and tingling sensations from those ulcers. You may have a fever and swollen lymph nodes if symptoms are severe.

When to see a doctor

See a doctor if you develop a high fever or your canker sores become larger, persist longer than two weeks, start to spread, and interfere with your eating and drinking.

Causes

The development of these ulcers can be triggered by

Eating foods containing citric acid, such as lemons or oranges.
Taking nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen.
Wearing braces or having poor-fitting dentures leading to irritation of oral tissues.
Dealing with stress and having inadequate sleep.
Deficiency of vitamin B-12, iron, zinc, and folic acid.

Complex canker sores can result from autoimmune diseases, AIDS, Behcet’s disease, celiac disease, Crohn’s disease, and ulcerative colitis.

Diagnosis

Your doctor will perform a physical exam and may order a blood test to check if you have nutritional deficiency or other health conditions causing canker sores.

Treatment

Even though the pain from canker sores can improve within a couple of days and the ulcers can resolve on their own within two weeks, you can use some medicated reliefs as follows:

Topical corticosteroid ointments.
Local anesthetics such as benzocaine.
Mouthwash containing chlorhexidine, dexamethasone, and hydrogen peroxide.

For recurrent canker sores, antibiotics such as doxycycline may be beneficial. If your canker sores are severe and do not respond to the abovementioned treatments, the doctor may cauterize the ulcer to relieve pain and accelerate healing.